血浆ZO-1蛋白浓度与脓毒症患者严重程度和30 d病死率的相关性分析

石强; 刘云; 周君

doi:10.13201/j.issn.1009-5918.2021.09.004

血浆ZO-1蛋白浓度与脓毒症患者严重程度和30 d病死率的相关性分析

- 苏州大学附属苏州九院(苏州市第九人民医院)急救重症科(江苏苏州,215200)
基金项目:
江苏省第十五批“六大人才高峰”高层次人才选拔项目(No:WSN-041)

详细信息

通讯作者: 周君,E-mail:29080127@qq.com

中图分类号: R631.2

收稿日期: 2021-06-23

Relationship between plasma ZO-1 protein concentration with sepsis severity and 30 day mortality

- Department of Emergency and Critical Care, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou Ninth People's Hospital, Suzhou, Jiangsu, 215200, China

More Information

Corresponding author: ZHOU Jun, E-mail: 29080127@qq.com

Received Date: 23 June 2021

摘要

摘要: 目的:探讨血浆闭合带(ZO)-1蛋白浓度与脓毒症患者的入院疾病严重程度和治疗30 d病死率的关系,为临床早期识别高危患者筛选敏感度和准确性更高的生化标志物。方法:本研究采用观察法,选择2018年1月-2021年1月期间入我院首次确诊为脓毒症的120例患者,同期选择健康体检者30例作为对照组,检测脓毒症患者入院24 h血浆ZO-1蛋白浓度,根据治疗30 d预后分为生存组77例和死亡组43例;比较组间患者临床资料和生化指标,分析ZO-1蛋白浓度与疾病严重程度的相关性,受试者工作曲线(ROC)分析ZO-1蛋白浓度预测30 d预后的效能,比较不同ZO-1蛋白浓度患者30 d的累积生存率。结果:脓毒症组ZO-1蛋白浓度明显高于对照组[2.3(1.2~3.6) ng/mL比1.1(0.6~1.5) ng/mL,P<0.001],与脓毒症患者急性生理与慢性健康评分(APACHEⅡ评分)和快速序贯性器官功能衰竭评分(qSOFA评分)呈现正相关(r分别为0.462和0.613,P<0.01),与氧合指数(PaO₂/FiO₂)呈现负相关(r=-0.525,P<0.01)。死亡组ZO-1蛋白浓度明显高于生存组[3.5(2.2,4.7) ng/mL vs.1.6(1.2,2.7) ng/mL,P<0.001],ROC分析显示,ZO-1蛋白浓度预测脓毒症患者30 d死亡的AUC值为0.823,临界值为2.2 ng/mL,高ZO-1组30 d累积生存率明显低于低ZO-1组(P<0.05)。结论:脓毒症患者入院血浆ZO-1蛋白浓度升高往往与疾病严重程度和30 d预后不良密切相关,有望成为预测疾病短期预后的重要生化指标。
- 闭合带-1蛋白 /
- 脓毒症 /
- 死亡 /
- 急性生理与慢性健康评分 /
- 快速序贯性器官功能衰竭评分
Abstract: Objective: To investigate the relationship between the concentration of plasma zonula occludens(ZO)-1 protein with the severity of sepsis and 30 day mortality, so as to screen biochemical marker with higher sensitivity and accuracy for early identification of high-risk patients.Methods: A total of 120 patients with sepsis for the first time who were admitted into our hospital from January 2018 to January 2021 were chosen, and 30 healthy people were selected as control group at the same time. The plasma ZO-1 protein concentration of sepsis patients was detected 24 hours after admission. According to the 30 day prognosis, sepsis patients were divided into survival group(n=77) and death group(n=43). The clinical data and biochemical indicators were compared, receiver operating curve(ROC) was used to analyze the efficacy of ZO-1 protein concentration in predicting 30 day prognosis, and the 30 day cumulative survival rate of patients with different ZO-1 protein concentrations was compared.Results: The concentration of ZO-1 protein in sepsis group was significantly higher than that in control group[2.3(1.2, 3.6) ng/mL vs. 1.1(0.6, 1.5) ng/mL, P<0.001], which was positively correlated with the acute physiology and chronic health score(APACHE Ⅱ) and quick sequential organ failure assessment(qSOFA)(r=0.462 and 0.613, P<0.01), and a negatively correlated with PaO₂/FiO₂(r=-0.525, P<0.01). The concentration of ZO-1 protein in death group was significantly higher than that in survival group[3.5(2.2, 4.7) ng/mL vs. 1.6(1.2, 2.7) ng/mL, P<0.001]. ROC analysis showed that the AUC value of ZO-1 protein concentration in predicting 30 day death of patients with sepsis was 0.823, and the cut-off value was 2.2 ng/mL. The 30 day cumulative survival rate of higher ZO-1 group was significantly lower than that of lower ZO-1 group(P<0.05).Conclusion: Increased plasma ZO-1 protein concentration in patients with sepsis is often closely related to the severity of disease and poorer 30 day prognosis, which is expected to become an important biochemical indicator for predicting the short-term prognosis.
- zonula occludens protein /
- sepsis /
- death /
- acute physiology and chronic health score /
- quick sequential organ failure assessment

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